Healthcare management has undergone major evolution in the recent past a complex and dynamic field so that changing needs of the patient population can be addressed optimally. Management aspects in healthcare sector aim at contributing towards the improvement of healthcare standards of the communities across the globe. Management skills are the most important skills required by the professionals working in the health care sector, as the implications of management aspects of the patient outcomes cannot be denied. A professional exhibiting management skill and competencies are better able to fulfil the comprehensive set of responsibilities entrusted to him (Delmatoff and Lazarus 2014). Among the diverse aspects of healthcare management, the most prominent one is healthcare leadership that has gained much attention in the recent past. It has been highlighted that leadership is needed for establishing and implementing modern organisational techniques and deliver maximum benefits to the patient population.
The following reflective essay aims at evaluating my management performance in relationship to healthcare leadership, which is a primary aspect of healthcare management. The paper involves the healthcare management aspect of leadership since it is pertinent to my role in the healthcare system. The essay provides a clear rationale for selecting the topic of healthcare leadership as the most important healthcare management aspect. The paper analyses my current role and responsibilities in relation to the chosen aspect of healthcare leadership. The following section is on the critical appraisal of my performance aligned with management theories. The paper would then provide a Personal Development Plan (PDP) that includes Specific Measurable, Achievable, Realistic, and Time related (SMART) goals.
At the initial stage of the paper, it would be preferable to explain the rationale behind selecting healthcare leadership as the aspect of healthcare management for this paper. The importance of healthcare leadership in the contemporary era is therefore put forward in here. Effective management concepts are constantly changing in the field of healthcare where healthcare professionals exhibit leadership skills for providing compassionate care (Quinn 2017). According to the researcher, the contemporary healthcare sector is facing a number of challenges such as evolving consumer expectations, demands for access to care, fiscal constraints and obligation to improved patient centred care. Effective leadership and governance are, therefore, crucial to maximise effective management of care in the different settings.
As pointed out by Martin (2015) leadership is inevitable for ensuring the safety of patients while receiving care. A number of healthcare organisations strive to achieve high reliability and reduce the number of adverse events occurring while delivering care. Due to a rapidly changing environment, care settings are consistently struggling to address hazardous situations arising due to flaws in the system as well as incompetency of professionals. The leadership of healthcare professionals is crucial in this regard for ensuring that the care delivered is safe and adverse events are negligible in number. It is to be noted that leadership has a key role in prioritising safety and promoting resolution of staff concerns. Importantly, a professional with leadership skills can manage unprofessional and disruptive behaviour through different skills. A structured approach can be fostered through leadership that has the potential to solve challenges and provide resolutions needed for results. A rich pool of literature has brought into focus that tragic failure in management and leadership in reputed care settings across the globe in the past have led to the urgency of addressing leadership in care settings (Sonnino 2016).
An analysis of my role and responsibilities in relation to the chosen aspect of healthcare leadership would form the next part of the paper. In the arena of healthcare management, leadership skill of a healthcare professional is the important aspect that is pertinent to my role of a theatre practitioner. A professional’s career as a theatre practitioner is both challenging and rewarding. Such a professional is a crucial part of the multidisciplinary operating theatre team who is responsible for providing patient-focused care at the time of anaesthesia, surgery and recovery. The key role of this professional is to respond to the psychological and physical needs of the patient (White, Lowes and Hormis 2015). Being a theatre practitioner, it is my responsibility to exhibit suitable leadership skills for enabling the multi-disciplinary team to deliver care in the required manner.
Leadership has been pointed out to be the driving factor behind supervision of a team, ensuring that chances of errors are less. My role as a theatre practitioner requires me to demonstrate suitable leadership skills for guiding the other members of my team and ensure that they follow the set guidelines and protocols for patient care (Mitchell 2017). For enabling better patient outcomes, it is necessary for me to maintain a healthy and amicable relationship with the team members involved since each member has an equally important role in patient safety. This amicable relationship can only be promoted if I as a theatre practitioner demonstrate suitable leadership skills.
In light of the valuable discussion put forward about the importance of healthcare leadership as part of the management process, and analysis of my role and responsibilities in this relation, it would be now appropriate to critically appraise my own performance with the help of management theories. My role as a ward leader (nursing unit) is to coordinate patient care activities and ensure their safety and quality of care at the hospital wards. According to National Medical Council (NMC) the UK, nurses who are involved in direct patient care should bring out their professional knowledge like leadership to promote trust and professionalism from people receiving care and in aspiring others (Sellman 2011). My leadership style was transformational where I focused on empowering staffs and helping them to achieve their goals. I performed the role of engaging and empowering my staffs being aware of the bigger vision of patient safety that is required for providing care on a daily basis and manages the ward in fulfilling the needs of the services provided to the patients (Masood and Afsar 2017).
However, on a particular day, that is being discussed in this paper, my role shifted from ward leader to theatre practitioner since I had to replace the theatre practitioner who had cancelled her shift that particular day. In the theatre, the team consisted of the surgeon, anaesthetist, anaesthetic practitioner, circulate nurse, scrub practitioner and theatre practitioner. One of the anaesthetic practitioners was recruited through an agency, and unfortunately, it was his first working day at the theatre. My leadership role changed and I was not aware of my role at the OT that particular day. Although, I was aware that leadership aspects are important in my current role as I am directly involved in patient care, I was unable to perform as it occurred suddenly. My current role aligns with situational leadership style where one needs to be adaptable and flexible to the needs of the team. In an operation theatre, a theatre practitioner needs to take up a participatory approach where all the staffs should be engaged in executing their individual roles and acting towards the common goal of patient safety before and during the surgery. My role was to work with the surgical team and anaesthetist to work well as a member of the healthcare team through effective leadership and communication. There was ineffective communication regarding the background of the patient who was being brought for the surgery. The anaesthetist was new to the job, and my leadership role changed as I was assigned to perform the role of theatre practitioner that particular day. Team monitoring and situation awareness were lacking in the whole scenario that was important to ensure patient safety and also from the perspective of efficiency. Situational leadership was demanded that I was lacking in the whole scenario.
At the Operation Theatre (OT), I was supposed to act in the situation where I should have collected medical history and background of the patient who as being brought for the surgery. It was a poor practice where the informed consent harmed the patient after being anaesthetised. I did not act according to the situation and understand the importance of informed consent that is important in ensuring patient safety. Transfer of professional responsibilities and accountability for the patient was on a temporary basis. There was ineffective communication between the members of the surgical team being the main cause for poor staff engagement leading to adverse situations (Moss et al. 2017). During the transition of the patient from ward to OT, it is important to transfer responsibility and accountability for the patient care as a result of ineffective communication. Being a theatre practitioner, prior to the surgery, it was my duty to look into the safety of the patient and manage the whole environment of the OT. Moreover, I need to look at the World Health Organization (WHO) checklist prior to the surgery being the most important protocol of a theatre practitioner. This checklist was mandatory for the safe surgery to reduce the chances of risk at the time of surgery and work towards patient safety. It was my duty to manage the equipment, instruments and perform the routine safety checks in the OT without compromising the patient safety and quality of care to be provided to the patient. According to WHO, for the successful accomplishment of surgery and patient safety, it is mandatory to evaluate the WHO checklist prior to surgery to ensure positive patient experience. It is a tool for patient safety communication that is used by OT professionals for discussing the surgical case.
After the patient had been anaesthetised and the professionals were ready with the WHO checklist, the anaesthetic practitioner reported that he did not check the consent of the patient. The consent could not be found after repetitive searching. Informed consent is the agreement or approval provision that is taken from patients prior to any medical procedure being of the most critical issue running through all aspects of provision of healthcare today. It is a primary paradigm for the protection of patients’ legal rights and guides the ethical medicine practice. In the healthcare system, informed consent affirms the elicitation of patient’s values that allows physicians including patients to reach to an agreement about medical care goals. Informed consent is central to decision-making where nature of the decision, reasonable alternatives, benefits, risks, patient understanding and intervention acceptance by the patient is discussed (Grady 2015). The consultant did not consider the situation to be favourable for proceeding with the surgery as she had not seen the patient before. It was highlighted that one of the registrars had seen the patient. However, the professional could not be contacted in that instance. As a result, the patient had to be reversed from the anaesthetic, and the consultant postponed the surgical procedure.
This scenario depicts that there is poor practice in relation to the informed consent prior to the medical procedure that hampered the patient safety as procedure was postponed without understanding the consequences. I was very disappointed with the anaesthetic practitioner who failed to check the patient’s consent and follow the protocol of WHO. I also felt sympathetic for the patient as she had to wait for a long time for the surgery that got postponed. The positive aspect was that the absence of the consent could be recognised and no harm was done to the patient. The key lesson learnt from the scenario was that taking consent from the patient is a legal requirement and safety of the patient is of prime importance. In addition, understanding the roles of team members helps in understanding the skills and qualities of the professionals in a team.
At this juncture, my performance, from the managerial point of view of leadership, can be explained by linking to management models of complexity and reflexivity. The complexity theory has the focus on interactions that are needed for adapting to the environment and coping up with the needs of the situation (Dunn 2016). Analysing my performance it is to be mentioned that failure to adhere to the model of complexity was the key factor driving my poor performance as a theatre practitioner. Complexity entails a leader to demonstrate situational leadership, which is the adaptive style of leadership encouraging the leader to take stock of the team members and act in a manner that best fits the circumstances. Situational leadership is all about flexibility, and the leader must be adapting to the needs of the environment and the changes in need of care. As a leader, I had the responsibility of understanding the needs of the present situation as a theatre practitioner and work accordingly. However, I was not able to demonstrate situational leadership skills. As stated by Esquivel et al. (2017), a situational leadership must have insight into the present situation, which I failed to have. Further, I was not flexible in moving seamlessly from one health care role to another in alignment with the principles of complexity. Moreover, a person must have the ability to solve problems in an efficient manner for demonstrating skills of complexity model. In the present context, I was unable to solve the issue of the absence of the consent in a suitable manner.
Reflexivity is the process of questioning and exposing one’s actions and beliefs. Reflexive practice is a relational activity highlighting issues of situated timing, rhythm and judgement within conversations. The reflexive practice has the focus on respectful, safe and inclusive communication. Further, such a practice is related to empowerment (West et al. 2014). Based on the outcomes of the scenario, it is to be brought into notice that I was deviated from my responsibility to demonstrate reflexive practice. The communication that I took part in with the members of my multidisciplinary team was not inclusive, as I did not communicate the need of the patient consent prior to application of anaesthesia. Further, it would have been better if I had engaged myself in a respectful communication with the patient and apologised for the inconvenience caused. Lastly, I failed to empower my team mates, especially the anaesthetist practitioner to follow the guidelines of WHO and study the consent before applying anaesthesia.
The role of the care organisation in engaging in effective management practice might also be pinpointed in here. From the managerial perspective, two factors attributed to the undesirable scenario. Firstly, it was a wrong decision on the manager’s part to entrust me the role of theatre practitioner since it was different from the role of a team leader. The organisation should have had provision for adequate staffing in order to replace one theatre practitioner with another professional from the same field (Wyatt 2015)s. Further, the recruitment process was faulty as one of the anaesthetic practitioner was recruited through an agency and adequate training was not provided to him before commencing her practice within the multidisciplinary team (Gopee and Galloway 2017).
In this section of the paper, a personal development plan is to be outlined that points out the process of my goal setting and planning for own development based on the above evaluation of my performance. The key goal of my plan would be to enhance my leadership skills, as sharpening my skills would help me to manage my team in a better way. Further, I plan to set my skills aligned with the goals and priorities of the organisation that are changing constantly. The competency of appropriate leadership can take a professional to great heights.
My plan for the development of leadership skill can be explained through SMART objectives. SMART goals are commonly defined as Specific, Measurable, Achievable, Relevant, and Time-Bound. The specific goal that I have is to become a better leader who can exhibited situational leadership skills since at present I lack this certain leadership skills. It is important that the goals are measurable for determining the success and the milestone to be achieved. In the present context, my development is to be measured by examples of incidents where I would be able to demonstrate situational leadership. The idea is to avoid situations, similar to the one mentioned in the present paper in future. Its goals are unattainable then one would find himself discouraged in making progress. In the present case, my goal would be achievable in that there would be no repetitions of the present situation in future and that I would be able to promote team work in my multidisciplinary team. Since leadership is an ongoing journey, once the goal is achieved one can set another goal for more development. Relevance in goal is important so that it links the needs of the manager and the organisation. In this context, I would mention that my goal would be relevant as situational leadership is essential for the overall functioning of the care setting. If the team of healthcare professionals is efficient enough, the reputation of the organisation would certainly increase. For a goal to be time-bound, a deadline is to be set, within which it is to be achieved. My goal is to develop my leadership skills within six months period (Galea 2017).
The recommendations put forward by Thompson and Glasø (2015) would be adhered to for improving my situational leadership skills as per the SMART goal outlined above. Firstly, I would learn the methods of understanding the competency level of my team members. This would enable me to understand their willingness to follow my supervision. I would also enable myself to be more realistic about the work designated to each member of the team. Developing the ability to appreciate team members is also a key approach. I would be keen on learning more on how to deal with people who fit into different job role. Communication is a key aspect of leadership, and thus I would take part in a vocational course on professional communication that would be aligned with my goal. Lastly, I would engage myself in solving problem-based scenarios through online portals that focus on critical thinking process and decision making ability of situational leaders.
Coming to the end of the paper it can be concluded that the significance of effective leadership in allowing high quality care system cannot be denied. Leadership is known to provide efficient and safe care, and this has been repetitively pointed out in literature including research papers and government reports. Since the promotion of healthcare leadership is critical for achievement and sustenance of care quality improvements, I, as a healthcare professional, need to demonstrate key leadership skills in due course of my practice. My personal development plan is directed towards the development of leadership skills that would ensure that I am able to take up a managerial role in care settings in future. Upon fulfilling this plan, my actions would be aligned with the requirements of the organisation and the needs of my professional development.
References
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Dunn, R., 2016. Dunn and Haimann’s Healthcare Management. Health Administration Press.
Esquivel, M.I.V., Wallace, B., Du, X., Parks, C., Chang, Y.H., Brito, A., Ong, F.L., Yorks, L., Marsick, V., Gordon, E.W. and Mac Quarrie, A., 2017. Readdressing Situational Leadership in the New World Order through Technology. In Encyclopedia of Strategic Leadership and Management (pp. 553-566). IGI Global.
Galea, M., 2017. Applying leadership styles to the healthcare sector. Primary Care Management, 6(1), p.26.
Gopee, N. and Galloway, J., 2017. Leadership and management in healthcare. Sage.
Grady, C., 2015. Enduring and emerging challenges of informed consent. New England Journal of Medicine, 372(9), pp.855-862.
Martin, G.P., 2015. Responsibilising managers and clinicians, neglecting system health? What kind of healthcare leadership development do we want?: Comment on” Leadership and leadership development in healthcare settings-a simplistic solution to complex problems?”. International journal of health policy and management, 4(1), p.43.
Masood, M. and Afsar, B., 2017. Transformational leadership and innovative work behavior among nursing staff. Nursing Inquiry.
Mitchell, L., 2017. Safer surgery: analysing behaviour in the operating theatre. CRC Press.
Moss, S., Mitchell, M., Thomson, A., Piskor, M., Biles, C. and Casey, V., 2017. The key to improving clinical handover practices. Nursing management, 48(11), pp.45-51.
Quinn, B., 2017. Role of nursing leadership in providing compassionate care. Nursing standard (Royal College of Nursing (Great Britain): 1987), 32(16-19), pp.53-63.
Sellman, D., 2011. Professional values and nursing. Medicine, Health Care and Philosophy, 14(2), pp.203-208.
Sonnino, R.E., 2016. Healthcare Leadership Development and Training: Progress and Pitfalls. JMCN, p.17.
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